NRBS 3410 Exam 3 Blueprint
Health Assessment and Promotion
(New York University)
, NRBS 3410
Summer 2025
Exam 3 Test Map
Approximately 65-70 NCLEX Style Questions
TOPIC INCLUDING # of Directly from powerpoint
BUT NOT LIMITED Question
TO: s
Nursing Care of Pain 2-4 • Preparation-women who have participated in childbirth education report better pain management
Management in Labor • Support-women who have a dedicated person providing labor support report better pain management and
Pharmacologic and greater satisfaction with birth. •DOULA- certified, volunteer or paid individual who is trained to support a
non-pharmacologic woman through labor. Not a midwife •Positioning-lithotomy position is linked with longer labor and greater
reported labor pain
Non-pharmacologic •Relaxing and breathing techniques ◦ Relaxation-centered, nurse or partner
participation ◦ Imagery and visualization-what is important to patient ◦ Music-maternal choice ◦ Touch and
massage-maternal choice ◦ What works at 4cm may not work at 8 cm ◦ Conscious breathing-centering ◦
Effleurage and counter-pressure ◦ Effleurage is rhythmic and light touch of abdomen with a circular motion
◦ Water therapy (hydrotherapy) ◦ Appropriate only if membranes are NOT Ruptured
Pharmacologic Measures •Systemic analgesia: Morphine •Regional or local anesthesia: spinal or pundenal
block •Epidural: A neuraxial analgesia/anesthesia technique, continuously or intermittently into epidural or
intrathecal space. •Most common 75% of births in US are with epidural •Combination of local anesthetic
(bupivacaine) and opiod (fentanyl)
Systemic Analgesia ● Route: typically administered parenterally through existing IV line
● Drugs
Most commonly used
● Opioids Morphine, Butorphanol (Stadol),
meperidine (Demerol)
● Ataractics (hydroxyzine, promethazine)
● Benzodiazepines (diazepam, midazolam)
Nursing Care S 8-16
Management of:
Normal Postpartum
Care
Key Points
,● Uterus involutes rapidly after birth, returning to true pelvis within 2 weeks
● Rapid decrease in estrogen and progesterone levels after expulsion of
placenta responsible for triggering many anatomic and physiologic
changes in puerperium
● Hemorrhage is #1 cause of maternal morbidity and mortality
● Assessment of lochia and fundal height is essential to monitor
progress of normal involution and identify potential problems
● Return of ovulation and menses is determined in part by whether
woman breastfeeds infant
● Few alterations in vital signs are seen after birth under normal
circumstances
● Hypercoagulability, vessel damage, and immobility predispose
the woman to thromboembolism
● Marked diuresis, decreased bladder sensitivity, and
overdistention of the bladder can lead to problems with urinary
elimination
● Pregnancy-induced hypervolemia allows women to tolerate
considerable blood loss at birth
● Puerperium: period after delivery of
placenta, lasting for 6 weeks
● Postpartum period is interval between birth and
, return of reproductive organs to their non-
pregnant or pre-pregnant state
● Referred to as puerperium (postpartum) or fourth
stage of pregnancy
● 6 weeks
● Uterus
● Involution: rapid reduction in size and return of
uterus to non-pregnant state following birth and
separation of placenta
● Placental site heals without scar
● 2 cm below umbilicus at end of 3rd stage of labor
● Within appx 12 hrs returns to appx umbilicus (+/- 1
cm)
● Progresses rapidly
● Fundus descends 1 to 2 cm every 24 hours
● 2 weeks after childbirth uterus lies in true pelvis
● Uterus
● Subinvolution: failure of uterus to return to
nonpregnant state
● Risk is for Maternal Hemorrhage
● Common causes are retained placental
Health Assessment and Promotion
(New York University)
, NRBS 3410
Summer 2025
Exam 3 Test Map
Approximately 65-70 NCLEX Style Questions
TOPIC INCLUDING # of Directly from powerpoint
BUT NOT LIMITED Question
TO: s
Nursing Care of Pain 2-4 • Preparation-women who have participated in childbirth education report better pain management
Management in Labor • Support-women who have a dedicated person providing labor support report better pain management and
Pharmacologic and greater satisfaction with birth. •DOULA- certified, volunteer or paid individual who is trained to support a
non-pharmacologic woman through labor. Not a midwife •Positioning-lithotomy position is linked with longer labor and greater
reported labor pain
Non-pharmacologic •Relaxing and breathing techniques ◦ Relaxation-centered, nurse or partner
participation ◦ Imagery and visualization-what is important to patient ◦ Music-maternal choice ◦ Touch and
massage-maternal choice ◦ What works at 4cm may not work at 8 cm ◦ Conscious breathing-centering ◦
Effleurage and counter-pressure ◦ Effleurage is rhythmic and light touch of abdomen with a circular motion
◦ Water therapy (hydrotherapy) ◦ Appropriate only if membranes are NOT Ruptured
Pharmacologic Measures •Systemic analgesia: Morphine •Regional or local anesthesia: spinal or pundenal
block •Epidural: A neuraxial analgesia/anesthesia technique, continuously or intermittently into epidural or
intrathecal space. •Most common 75% of births in US are with epidural •Combination of local anesthetic
(bupivacaine) and opiod (fentanyl)
Systemic Analgesia ● Route: typically administered parenterally through existing IV line
● Drugs
Most commonly used
● Opioids Morphine, Butorphanol (Stadol),
meperidine (Demerol)
● Ataractics (hydroxyzine, promethazine)
● Benzodiazepines (diazepam, midazolam)
Nursing Care S 8-16
Management of:
Normal Postpartum
Care
Key Points
,● Uterus involutes rapidly after birth, returning to true pelvis within 2 weeks
● Rapid decrease in estrogen and progesterone levels after expulsion of
placenta responsible for triggering many anatomic and physiologic
changes in puerperium
● Hemorrhage is #1 cause of maternal morbidity and mortality
● Assessment of lochia and fundal height is essential to monitor
progress of normal involution and identify potential problems
● Return of ovulation and menses is determined in part by whether
woman breastfeeds infant
● Few alterations in vital signs are seen after birth under normal
circumstances
● Hypercoagulability, vessel damage, and immobility predispose
the woman to thromboembolism
● Marked diuresis, decreased bladder sensitivity, and
overdistention of the bladder can lead to problems with urinary
elimination
● Pregnancy-induced hypervolemia allows women to tolerate
considerable blood loss at birth
● Puerperium: period after delivery of
placenta, lasting for 6 weeks
● Postpartum period is interval between birth and
, return of reproductive organs to their non-
pregnant or pre-pregnant state
● Referred to as puerperium (postpartum) or fourth
stage of pregnancy
● 6 weeks
● Uterus
● Involution: rapid reduction in size and return of
uterus to non-pregnant state following birth and
separation of placenta
● Placental site heals without scar
● 2 cm below umbilicus at end of 3rd stage of labor
● Within appx 12 hrs returns to appx umbilicus (+/- 1
cm)
● Progresses rapidly
● Fundus descends 1 to 2 cm every 24 hours
● 2 weeks after childbirth uterus lies in true pelvis
● Uterus
● Subinvolution: failure of uterus to return to
nonpregnant state
● Risk is for Maternal Hemorrhage
● Common causes are retained placental
